Tranexamic Acid Therapy (TXA)
Plasminogen pathway control for stubborn pigmentation & melasma
이 치료에 대해
Tranexamic acid (TXA) is a lysine analog that inhibits the plasminogen activation pathway. Originally a hemostatic agent, TXA calms melanocyte hyperreactivity and suppresses prostaglandin/arachidonic acid production for fundamental pigmentation improvement.
Particularly effective for treatment-resistant melasma via oral, topical, and intradermal injection. Different mechanism from hydroquinone enables synergistic combination therapy.
작용 기전
TXA inhibits plasminogen-to-plasmin conversion, blocking pigmentation signaling from keratinocytes to melanocytes (UV-stimulated plasmin→arachidonic acid→PGE2 pathway). Fundamentally suppresses melanocyte activation and melanin synthesis while reducing dermal inflammation.
적응증
기대 효과
Oral (250-500mg/day): significant melasma improvement at 8-12 weeks. Topical (2-5% cream): pigmentation score improvement at 12 weeks. Intradermal injection: effective for stubborn melasma in 4-6 sessions. PIH prevention when combined with laser.
임상 근거
위험 및 부작용
Oral: rare GI symptoms. Thrombosis risk (caution with history/OCP users). Long-term safety data limited to 3-6 months. Topical: rare irritation. Injection: transient redness/swelling. Contraindicated in renal impairment.